A disorder resulting from the use of hand-held vibration tools (pneumatic drills, electric polishers, gas-powered chainsaws). Symptoms consist of: a circulatory disturbance, specifically vasospasm with finger blanching (secondary Raynaud phenomenon); sensorineural changes (numbness and decreased sensitivity), principally limited to the fingers; and various skeletal abnormalities affecting the hand and forearm; may be unilateral or bilateral; initially episodic and triggered by cold exposure, but may ultimately progress and become constant; often carpal tunnel syndrome is associated.